At-Risk Alcohol Use Among HIV-Positive Patients and the Completion of Patient-Reported Outcomes
Heavy drinking is prevalent among people living with HIV. Studies use tools like patient-reported outcomes (PROs) to quantify alcohol use in a detailed, timely manner. However, if alcohol misuse influences PRO completion, selection bias may result. Our study included 14,145 adult HIV patients (133,036 visits) from CNICS who were eligible to complete PROs at an HIV primary care visit. We compared PRO completion proportions between patients with and without a clinical diagnosis of at-risk alcohol use in the prior year. We accounted for confounding by baseline and visit-specific covariates. PROs were completed at 20.8% of assessed visits. The adjusted difference in PRO completion proportions was −3.2% (95% CI −5.6 to −0.8%). The small association between receipt of an at-risk alcohol use diagnosis and decreased PRO completion suggests there could be modest selection bias in studies using the PRO alcohol measure.
KeywordsPatient-reported outcomes PROs HIV Alcohol consumption Selection bias
This project was supported by Grant Numbers T32ES007018, R01AI100654, R24AI067039 and P30AI50410 from the National Institutes of Health. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health. Dr. Stephen Cole and Dr. Jessie Edwards provided expert advice and consultation throughout the project process. The Center for AIDS Research Network of Integrated Clinical Systems supplied the data and information on the cohort and linked us to our CNICS collaborators, including Dr. Moore, Dr. O’Cleirigh, Dr. Christopoulos, and Dr. Mathews.
Compliance with Ethical Standards
Conflict of interest
All authors declare that they have no conflicts of interest.
This article does not contain any studies with human participants or animals performed by any of the authors. This study was reviewed by the Office of Human Research Ethics at the University of North Carolina at Chapel Hill and was determined to not constitute human subjects research as defined under federal regulations.
- 8.Lawrence ST, Willig JH, Crane HM, Ye J, Aban I, Lober W, et al. Routine, self-administered, touch-screen, computer-based suicidal ideation assessment linked to automated response team notification in an HIV primary care setting. Clin Infect Dis. 2010;50(8):1165–73.CrossRefPubMedPubMedCentralGoogle Scholar
- 14.Bush K, Kivlahan DR, McDonell MB, Fihn SD, Bradley KA. The AUDIT alcohol consumption questions (AUDIT-C): an effective brief screening test for problem drinking. Ambulatory Care Quality Improvement Project (ACQUIP). Alcohol Use Disorders Identification Test. Arch Intern Med. 1998;158(16):1789–95.CrossRefPubMedGoogle Scholar